This document represents an aggregated, ordered and contextualized view of the material we've been able to compile and publish that is related to the topic of "Claim Pend Management." The goal is to make this page a landing and launch point for all things related to this topic. As our content becomes more complete and more accurate, this page should become a very useful and powerful knowledge base for this topic and all parties interested in it.

You'll find that the content for this document is consistent with that of other discipline related documents. This is intentional. The consistency is based on a knowledge pattern that helps individuals learn more about different topics, quicker and more efficiently. We hope you find the material useful and easy to learn.

It's important to realize that content in this document and any related sub-documents are constantly evolving. Therefore, we recommend you check for updates, regularly, to keep up with the latest material.

The Foundation always welcomes your feedback and suggestions for improvement, as we're always looking for ways to improve our solutions and offerings to the general community.

All solutions published by the Foundation are subject to the terms and conditions of the Foundation's Master Agreement.

This document or artifact, along with everything in it, is intended to act as a "Framework" that addresses various aspects of Claim Pend Management.

The readers will notice that most sections in the Table of Contents (TOC) use a format where the TOC entry is prefixed with a topic name, followed by a short descriptive title (i.e. "TOPIC_NAME: TOPIC_RELATED_SECTION_TITLE"). This is intentional and represents a format by which the Foundation may achieve things like the identification of appropriate topic areas, the segregation of distinct topic areas from each other, the appropriate ordering of topic areas, and achieve the maintenance of consistency, both, within and across different IT Disciplines.

To elaborate, this artifact is intended to:

Organize different areas of the discipline known as Claim Pend Management into clear and compartmentalized areas that allow the Foundation to more effectively and productively collect, document and publish information that pertains to this discipline.

Decompose each area of Claim Pend Management into smaller and, therefore, more digestible units for more efficient learning and understanding.

Document common industry wisdom about each area, piece or subcomponent of Claim Pend Management

Act as a set of Claim Pend Management related best practices and guidelines that have been collected, documented, and published for the benefit of IT Professionals, regardless of their specific industry, line of business, or area of expertise.

Act as a consistent and repeatable pattern for documenting, publishing and learning, both, within this Discipline and across "all" Disciplines.

From the Foundation's perspective, if done correctly, all of the above will allow the Foundation to properly decompose, document and publish content related to each sub-area or sub-topic for each IT Discipline, including this specific discipline (i.e. "Claim Pend Management").

From the reader's perspective, if done correctly, all of the above will allow him or her to easily find and learn about specific areas of interest associated with this and all other IT Disciplines in a manner where the reader may effectively consume and digest material in small atomic segments that act as repeatable and more effective learning units.

As this artifact evolves and progresses, the reader will see it address key areas of the professional IT Discipline "Claim Pend Management" that range from its detailed definition through closely related terms, phrases and their definitions, to its detailed specification of Claim Pend Management Capabilities, and all the way through to defining, delivering, operating and supporting Claim Pend Management Services.

As mentioned previously, this document will continue to evolve and the Foundation recommends the reader check back, regularly, to stay abreast of modifications and new developments. It is also important to understand that the structure of this artifact may change to meet the needs of such evolution.

Before moving on to learn more about the rest of the Claim Pend Management framework, we suggest that you take some time to familiarlize yourself with the following very basic term(s)...

Claim Pend:

"1. An unprocessed or non-adjudicated Claim, often due to some unresolved rule, that has resulted in a hold or exception, as it waits to continue being processed or adjudicated."

Claim Pend Management:

"1. The professional discipline that involves working with, in or on any aspect of planning, delivering, operating or supporting for one or more Claim Pend Items or any and all solutions put in place to deal with such Items.

2. The solution set that a person or organization puts in place to manage one or more Claim Pend Items.

3. The process or processes put in place by a person or organization to assist in the management, coordination, control, delivery, or support of one or more Claim Pend Items.

4. The Enterprise Capability that represents the general ability or functional capacity for a Resource or Organization to deal with or handle one or more Claim Pend Items. Such a term is often used by Information Technology (IT) Architects when performing or engaging in the activities associated with general Capability Modeling."

In addition to the above basic term(s), you can also learn a great deal about Claim Pend Management by familiarizing yourself with the broader spectrum of terms that make up the Claim Pend Management Glossary...

Language between IT professionals and the businesses we serve is often a significant barrier to success, as we often spend countless hours trying to interpret each other's meanings. This is often also true between IT professionals who are taught to use certain terms and definitions as part of the organizations and industries they serve. It's when you start to jump from organization to organization, from enterprise to enterprise, and from industry to industry that you realize how much time and effort is wasted on just getting language and meanings correct. For these reasons, the Foundation puts a great deal of focus on terms and phrases, as well as their corresponding definitions. We highly recommend you spend time learning and understanding all of the related terms and phrases, along with their meanings, for all areas of "Claim Pend Management."

Please refer to the IT Glossary for other terms and phrases that may be relevant to this professional discipline.

Readers may also refer to the Taxonomy of Glossaries for terms and phrases that are semantically grouped according to IT Disciplines or enterprise domains.

This Claim Pend Management Glossary is a contextual subset of the master IF4IT Glossary of Terms and Phrases. The master glossary can be used by you and your enterprise as a foundation for broader understanding of Information Technology and can be used as a teaching and learning tool for those you work with, helping to ensure a common and more standard language.

A Capability, as it pertains to Information Technology (IT) or to an enterprise that an IT Organization serves, is defined to be "A manageable feature, faculty, function, process, service or discipline that represents an ability to perform something which yields an expected set of results and is capable of further advancement or development. In other words, a Capability is nothing more than "the ability to do something" or, quite simply, a Feature or Function. Therefore, when applied to an enterprise, a Capability represents a critical Enterprise Feature or Enterprise Function.

When it comes to Capabilities, there are multiple types that an enterprise needs to be aware of. Examples include but are not limited to:

Business Capabilities: A set of Capabilities needed and/or offered by a Business.

Information Technology (IT) Capabilities: A set of Capabilities needed and/or offered by an IT Organization.

System Capabilities: A set of Capabilities needed and/or offered by a System

Service Capabilities: A set of Capabilities needed and/or offered by a Service

Organizational Capabilities: A set of Capabilities needed and/or offered by one or more Organizations.

Enterprise Capabilities: A set of Capabilities needed and/or offered by an Enterprise (i.e. the combined set of all of the above).

As can be seen above, there are Capabilities that are associated with Resources, Organizations, and Assets such as Systems. All are important to an enterprise.

In the case of this IT Discipline (i.e. Claim Pend Management), we use the word Capability in the context of an Enterprise Capability or an IT Capability, which are both equivalent to Enterprise Disciplines or IT Disciplines, respectively. In short, the Capability of Claim Pend Management represents the ability to deal with any and all Claim Pend Items and anything relevant that is related to or associated with any Claim Pend Items.

If you think about it, a capability is really nothing more than a "verb" or "action that represents "the ability to do something." Understanding this allows us to derive a consistent and highly repeatable set of sub-capabilities for any Noun we're dealing with. For example:

The ability to architect a specific Noun.

The ability to copy a specific Noun.

The ability to create a specific Noun.

The ability to delete a specific Noun.

The ability to design a specific Noun.

The ability to edit a specific Noun.

The ability to modify a specific Noun.

The ability to purge a specific Noun.

The ability to request a specific Noun.

Etc. (The list is quite long.)

In summary, the implication is that the Enterprise Capability or Enterprise Discipline known as Claim Pend Management is the superset of all the above Sub-Capabilities, as they pertain to or are applied to the discipline-specific Noun: "Claim Pend." This now translates more specifically to:

The ability to architect a specific Claim Pend Item.

The ability to copy a specific Claim Pend Item.

The ability to create a specific Claim Pend Item.

The ability to delete a specific Claim Pend Item.

The ability to design a specific Claim Pend Item.

The ability to edit a specific Claim Pend Item.

The ability to modify a specific Claim Pend Item.

The ability to purge a specific Claim Pend Item.

The ability to request a specific Claim Pend Item.

Etc. (The list is quite long.)

For a more complete list of very specific Capabilities/Disciplines, refer to the Foundation's Master Inventory of IT Disciplines. It is important to note that this inventory is in a flat or non-hierarchical form, specifically because "hierarchy" is almost always a matter of personal preference or context (what hierarchy is important to one Resource or Organization may be unimportant to another's needs or requirements). Therefore, the Foundation has published its inventory of Capabilities in a non-hierarchical, flat form.

This now brings us to a very obvious problem that surrounds Capabilities, which is the fact that there are simply too many "granular" or "specific" Capabilities to document and publish in any single Capability Model. The end result is that a Capability Model may become unwieldy because of trying to incorporate so many different specific Capabilities. Also, Capability Modeling "Purists," who all have their own (and very differing) opinions about how Capability Models should or should not be represented, almost always refuse to get into the details. To address this, we recommend using a generic set of Capabilities that map to and are driven by the Systems Development Life Cycle. For example:

Identify and Solicit Demand for Claim Pends

Create and Set Strategy for Claim Pends

Perform Research on or for Claim Pends

Plan for the Delivery of Claim Pends

Identify Requirements for Claim Pends

Define and Design Claim Pends

Build or Construct Claim Pends

Control Quality of or for Claim Pends

Deliver Claim Pends (to Meet Identified Demand or Desire)

Operate and Support Claim Pends

As you can see from the above, we now have a very limited, controlled and manageable set of Discipline-specific Capabilities for the Discipline Claim Pend Management.

As a reminder, the above Capability representations are "suggestions" for baselining or initializing your own Enterprise Capability Model (ECM). It's recommended that you take the time to work with your enterprise stakeholders to improve upon and/or customize your own ECM so that you can help meet their needs. However, with that being said, it's always a better idea to go in with a baseline that you can modify rather than building your own solution from scratch, especially if your goals are to standardize, not reinvent the wheel, and not deviate too far from what other enterprises are doing to model their own environments. This is especially true if you've never had any experience building ECMs that have gained and maintained full adoption.

Why do enterprises perform Capability Modeling? Enterprises most often build Capability Models that are associated with Claim Pend Management for the following reasons...

To create a common enterprise language for the Discipline known as Claim Pend Management.

To create a common and reusable Claim Pend Management Taxonomy (or a Taxonomy for Claim Pend Management). Such Taxonomies can be used to help layout or structure an enterprise's Intranet (often for routing and/or traverse-ability) and tag Documents in Document Management Systems.

To create a "Knowledge Map" or "Knowledge Model" for Claim Pend Management. Such Knowledge Maps or Models can then be translated and used for structuring training programs, establishing Communities of Practice (CoPs), and defining and publishing things like policies, processes, procedures, and standards.

To help categorize and structure Requirements during Requirements collection and analysis.

To help map things like Applications, Software, and Hardware to the Capability areas of Claim Pend Management.

To help define enterprise Services, along with helping to understand who provides and consumes such services.

To help understand what activities go on, in an enterprise, and who performs such activities.

And much more...

Capability Modeling Recommendations: Some things to consider and keep in mind when working on or creating your Claim Pend Management and Enterprise Capability Models...

Try and keep "context" or "contexts" out of your core model. For example, your Claim Pend Management Stakeholders may work hard to get what's important to them into the model (e.g. their "organizations" or organizational contexts), as opposed to what might actually be best for the enterprise. It's always a good idea to keep the model as pure as possible and keep such contexts out.

While it's a good idea to keep contexts out of your core Capability Model, it will eventually become clear that Capability Contexts are, in fact, very important to your enterprise. You will have to find a way to model and represent such contexts, separately. For example, one context might be an organizational view of what organizations provide or consume specific Capabilities, such as Claim Pend Management. Such contexts often represent "cross sectional" or "pivoted" views of your model.

One of the quickest ways to lose the interest of your enterprise is to keep your model secluded or silo-ed in a spreadsheet or database and not publish it or use it for solving other problems in the enterprise. A good Enterprise Capability Model (ECM) helps get to better Service Management Models, better Document Management Taxonomies, and (most importantly) to better Knowledge Models that can be published as traversable content on your Intranet so that stakeholders can, find, learn about, better understand and use such Capabilities.

Once you embark on building an ECM, you will undoubtedly run into the challenge that your Business doesn't speak in terms of "Capabilities." Remember, Capability Models are things that were designed by Information Technology (IT) Architects that, very often, have never worked in a Business, built a Business, or run a Business. Some times, it's better to build models using terminology your Business understands, such as "Services," "Features," or "Functions," all terms that most Businesses are far more familiar with. However, this should not be interpreted as a deterrent to keep you from embarking on building an ECM, should it be the right thing to do for your enterprise.

You will be hard pressed to find many, if any, reusable Capability Models that can be used as solid reference material for your own models, which is why the Foundation has taken the time to document different aspects and issues associated with Capability Modeling and Capability Models.

You will constantly be under pressure to help define and get your Business Stakeholders to understand what a Capability is. It's for this reason that you may want to use terminology that might be more common with Businesses, such as "Services," "Functions," and/or "Features."

It's better to start with a model you can go into your Business Stakeholder meetings with, with the intent of improving upon what you have, than it is to go in with nothing at all and build your models from scratch.

Do your best to work with your Claim Pend Management Stakeholders to help verify and improve your Claim Pend Management Capability Model.

Don't assume that tools will help solve your Capability Modeling needs. It's always better to start simple and work your way up to tools, after you know what you want to achieve and can realistically achieve.

Good Capability Models will be many levels or layers "deep." Modelers that think they can represent their entire enterprise or all its key Capabilities in just a few levels of hierarchy are fooling themselves or trying to fool those that they're trying to sell their models to.

While Capability Models may look like "hierarchical" structures when building your first few layers, good Capability Models will eventually start to share common Capabilities in different areas of the model, forcing the model to take on the structure of a multidimensional "graph."

Keep your model published and fresh so that the enterprise can see it and use it, immediately. The more eyes you have on your model, the faster it will improve.

Learn More About Capability Models: Taking the time to learn about and understand Capability Models, what they're for, and how they're used may help you learn how Claim Pend Management better fits into the broader enterprise. Therefore, we suggest you spend some time reviewing and understanding the IF4IT Enterprise Capability Model...

Here's a very simple fact... If an enterprise does not establish and enforce clearly defined Ownership (i.e. a Resources and his or her Organization are assigned as accountable ownership) for Claim Pend Management, the enterprise has automatically set itself up for failure in its implementation of that discipline. Therefore, if you and your enterprise want to implement and maintain a successful solution for Claim Pend Management, there must be a clearly defined Owner that can and will be held accountable for getting work done, providing transparency, helping with strategy setting, and coordinating implementation of Claim Pend Management as a fully functional and mature enterprise Service.

Having clearly defined Ownership should not be confused with having fully dedicated Resources that spend one hundred percent of their time working on Claim Pend Management. In fact, smaller enterprises can rarely afford to dedicate full time Resources, like larger enterprises can, to all enterprise IT Disciplines. This being the case, all IT Disciplines, including Claim Pend Management, should "always" have clearly defined Owners so that there is always a clear point of accountability and contact for any issues or work that need to be addressed.

In addition to the common best practice of having clearly assigned Ownership for Claim Pend Management, it is also considered a best practice to clearly publish and socialize Claim Pend Management Ownership details to a centralized location (often referred to as a "Service Catalog" or an "Enterprise Service Catalog"), along with Ownership details for all other IT Disciplines, so that the entire enterprise has constant access to it.

Figure: How Ownership of the Capability Claim Pend Management fits into the Canonical Model for IT

The above figure helps us understand how Capability or Discipline Ownership fits into the Canonical Model for Information Technology (IT) (i.e. "Think," "Deliver," and "Operate"). Owners are assigned to individual Disciplines or Capabilities, such as Claim Pend Management, and are instantly made accountable to the enterprise for the results of all Claim Pend Management Thinking activities (i.e. Strategy, Research, Planning and Design), all Claim Pend Management Delivery activities (i.e. Construction, Deployment and Quality Assurance), and all Claim Pend Management Operations activities (i.e. Use, Maintenance and Support). Done correctly, Claim Pend Management Ownership is constant and ongoing. It's important to understand that such assigned Ownership should "never" end so that there is clear and constant accountability and transparency for all aspects of the Canonical Model to the enterprise.

Not having clear Ownership for Claim Pend Management means that there is no clear understanding of who is accountable for it, who can provide understanding of what's going on within it, who can help the enterprise provide short term and long term descriptions of work being performed within the Discipline area to improve it over time for its customers, and who can help with getting work done that's associated with it. It means your or your enterprise's implementation for Claim Pend Management will be highly incomplete and erratic because no one is constantly (or even partially) watching over the Discipline and its needs for maintenance and evolution. Not having clear Claim Pend Management Ownership is a recipe for confusion and, sometimes, even chaos.

In summary, if you and your enterprise truly want to be successful with your implementation of Claim Pend Management, ensure that a clear and highly accountable owner is identified and assigned to the Discipline. Publish those ownership details, preferably in an enterprise's Service Catalog, and socialize it so everyone knows whom to go to for answers and for help with Claim Pend Management related work. In other words, if you want to implement Claim Pend Management as an enterprise Service, then you absolutely must start with clearly defined, published and socialized Ownership.

Throughout the Foundation's documentation, you will continuously run into the references of "Nouns and Verbs." These concepts are key to consistency and standardization, throughout the IT Industry, down to each and every IT Discipline. Given that we've discussed the impact of "Nouns" on the discipline of "Claim Pend Management," this section will start to discuss the importance of "Verbs" or "Actions" that can be performed with or against the key Noun or Nouns associated with this Discipline. To reiterate, Verbs or Actions allow us to clearly understand what can be performed on or with the Noun in question. As will be discussed in the next section, Verbs or Actions will also help us clearly identify whom it is (i.e. the "who" or more specifically the Roles) that performs or executes such Verbs or Actions against a Discipline and its associated Noun or Nouns. As will be discussed later, Verbs or Actions will also help identify key Attributes (i.e. Field Names) that are necessary for the very data definition of the Noun or Nouns for this Discipline and will even help identify which Verbs or Actions can be automated for this Discipline.

As a reminder, the base Noun for the discipline known as Claim Pend Management is: "Claim Pend," which is sometimes referred to as a the Noun: "Claim Pend Item."

By now, it should be becoming apparent that verbs represent a baseline for defining solid functional requirements and sub-capabilities for what would be a part of any good Claim Pend Management System or Service. What this means is that if you and/or your Organization is looking for a solution in this space (e.g. the purchasing or building of a software solution or the implementation of a Service to address the needs of Claim Pend Management), you could use discipline-related verbs to drive the foundation of what the solution should or shouldn't do, as mapped to specific stakeholders that will use or provide the solution.

Examples of the types of Verbs or Actions that are important to this Discipline include but are not limited to:

Architect

Create

Edit/Modify

Delete

Design

Copy

Own

Manage

Etc.

The above list represents a very small subset of all Verbs or Actions that are relevant for this Discipline. The more complete set can be found in the Roles section of this document, where readers can see the direct correlation of Verb to Noun and to, both, Generic Role and Discipline Specific Role.

An "action" or a "verb" is something that can be performed on or with a specific "noun." The reason it is important to itemize all relevant verbs is because we can now start to determine what we can or cannot do with the noun in question, where in this case the noun is "Claim Pend."

Actions/Verbs

Example as Applied to "Claim Pend"

Generic Roles

Discipline-Specific Roles

Administrate

Administrate Claim Pend

Administrator

Claim Pend Administrator

Approve

Approve Claim Pend

Approver

Claim Pend Approver

Architect

Architect Claim Pend

Architector

Claim Pend Architector

Archive

Archive Claim Pend

Archiver

Claim Pend Archiver

Audit

Audit Claim Pend

Auditor

Claim Pend Auditor

Bundle

Bundle Claim Pend

Bundler

Claim Pend Bundler

Clone

Clone Claim Pend

Cloner

Claim Pend Cloner

Code

Code Claim Pend

Coder

Claim Pend Coder

Configure

Configure Claim Pend

Configurer

Claim Pend Configurer

Copy

Copy Claim Pend

Copier

Claim Pend Copier

Create

Create Claim Pend

Creator

Claim Pend Creator

Decommission

Decommission Claim Pend

Decommissioner

Claim Pend Decommissioner

Delete

Delete Claim Pend

Deletor

Claim Pend Deletor

Deploy

Deploy Claim Pend

Deployer

Claim Pend Deployer

Deprecate

Deprecate Claim Pend

Deprecator

Claim Pend Deprecator

Design

Design Claim Pend

Designer

Claim Pend Designer

Destroy

Destroy Claim Pend

Destroyer

Claim Pend Destroyer

Develop

Develop Claim Pend

Developer

Claim Pend Developer

Distribute

Distribute Claim Pend

Distributor

Claim Pend Distributor

Download

Download Claim Pend

Downloader

Claim Pend Downloader

Edit

Edit Claim Pend

Editor

Claim Pend Editor

Educate

Educate Claim Pend

Educator

Claim Pend Educator

Export

Export Claim Pend

Exporter

Claim Pend Exporter

Govern

Govern Claim Pend

Governor

Claim Pend Governor

Import

Import Claim Pend

Importer

Claim Pend Importer

Initialize

Initialize Claim Pend

Initializer

Claim Pend Initializer

Install

Install Claim Pend

Installer

Claim Pend Installer

Instantiate

Instantiate Claim Pend

Instantiator

Claim Pend Instantiator

Integrate

Integrate Claim Pend

Integrator

Claim Pend Integrator

Manage

Manage Claim Pend

Manager

Claim Pend Manager

Merge

Merge Claim Pend

Merger

Claim Pend Merger

Modify

Modify Claim Pend

Modifier

Claim Pend Modifier

Move

Move Claim Pend

Mover

Claim Pend Mover

Own

Own Claim Pend

Owner

Claim Pend Owner

Package

Package Claim Pend

Packager

Claim Pend Packager

Persist

Persist Claim Pend

Persister

Claim Pend Persister

Plan

Plan Claim Pend

Planner

Claim Pend Planner

Purge

Purge Claim Pend

Purger

Claim Pend Purger

Receive

Receive Claim Pend

Receiver

Claim Pend Receiver

Record

Record Claim Pend

Recorder

Claim Pend Recorder

Recover

Recover Claim Pend

Recoverer

Claim Pend Recoverer

Register

Register Claim Pend

Registrar

Claim Pend Registrar

Relocate

Relocate Claim Pend

Relocator

Claim Pend Relocator

Reject

Reject Claim Pend

Rejecter

Claim Pend Rejecter

Remove

Remove Claim Pend

Remover

Claim Pend Remover

Replicate

Replicate Claim Pend

Replicator

Claim Pend Replicator

Report

Report Claim Pend

Reporter

Claim Pend Reporter

Request

Request Claim Pend

Requestor

Claim Pend Requestor

Restore

Restore Claim Pend

Restorer

Claim Pend Restorer

Review

Review Claim Pend

Reviewer

Claim Pend Reviewer

Save

Save Claim Pend

Saver

Claim Pend Saver

Search

Search Claim Pend

Searcher

Claim Pend Searcher

Split

Split Claim Pend

Splitter

Claim Pend Splitter

Sponsor

Sponsor Claim Pend

Sponsor

Claim Pend Sponsor

Store

Store Claim Pend

Storer

Claim Pend Storer

Strategize

Strategize Claim Pend (or Set Claim Pend Strategy)

Strategizer (or Strategy Setter)

Claim Pend Strategizer (or Claim Pend Strategy Setter)

Support

Support Claim Pend

Supporter

Claim Pend Supporter

Test

Test Claim Pend

Tester

Claim Pend Tester

Train

Train Claim Pend

Trainer

Claim Pend Trainer

Upgrade

Upgrade Claim Pend

Upgrader

Claim Pend Upgrader

Upload

Upload Claim Pend

Uploader

Claim Pend Uploader

Verify

Verify Claim Pend

Verifier

Claim Pend Verifier

Version

Version Claim Pend

Versioner

Claim Pend Versioner

View

View Claim Pend

Viewer

Claim Pend Viewer

At a minimum, the above list of Verbs can be used to help identify, track, and manage the basic "Features" required by and associated with Claim Pend Management, even if your enterprise doesn't maintain a Capability Model that lists specific Claim Pend Management Capabilities. Application designers, developers, and architects often find such Verb Lists or Feature Inventories to be invaluable.

...a documented and orderly set of types, classifications, categorizations and/or principles that are often achieved through mechanisms including but not limited to naming, defining and/or the grouping of attributes, and which ultimately help to describe, differentiate, identify, arrange and provide contextual relationships between the entities for which the Taxonomy exists.

From this general definition, we can derive that the definition for a Claim Pend Management Taxonomy is:

...a documented and orderly set of types, classifications, categorizations and/or principles that are often achieved through mechanisms including but not limited to naming, defining and/or the grouping of attributes, and which ultimately help to describe, differentiate, identify, arrange and provide contextual relationships between Claim Pend Items, Entities or Types.

In short, what this means all means is that a Taxonomy is nothing more than a classification or typing mechanism and that a Claim Pend Taxonomy is nothing more than a classification or typing mechanism that helps people and systems distinguish between different Claim Pend Items, Entities, Types, Records or any other Claim Pend Management element you can think of.

It's important to understand that Taxonomies can be as simple as a list of relevant terms or phrases with respective meanings or definitions or they can take on more complex forms, such as hierarchical and graphical model structures that can be homogeneous and heterogeneous in nature. More complex Taxonomies include examples such as "Visual Taxonomies" and "Audible Taxonomies" but, expect in the case of very special technologies, are typically out of scope for general Information Technology (IT) Operations.

The Foundation directs readers to its ever-evolving Inventory of Taxonomies for Standard Taxonomy suggestions. Specifically, readers may want to start with the Taxonomy of Taxonomies, which helps make it clear that the IT Industry is composed of many hundreds if not thousands of Taxonomies, Classifications, Categorizations or Types.

While Taxonomies represent organized classifications or types, you can think of Ontologies as the design and representation of entire lanaguages, with the specific intent to control things like structure, behavior, representation, and meaning. Without getting into a theoretical conversations about Ontologies, you can view this entire article as a foundation for the ontology of Claim Pend Management. Or, in other words, a Claim Pend Management Ontology.

Throughout this artifact/framework, you will find things like Claim Pend Management related terms, phrases, definitions, roles, responsibilities, nouns, verbs, classifications, and so on, all as a means of definining a standard representation for and interpretation of the language of Claim Pend Management.

It is only through the definition, communication, and establishment of such Ontologies that we can standardize language and communication associated with Claim Pend Management, whether it be between humans and/or systems.

When we talk about Life Cycle (or lifecycle) for Claim Pend Management, it's important to keep in mind that there are two different types of Life Cycles that apply. The first is a Data Life Cycle, which addresses Claim Pend Management data or entities, and the second is associated with delivering Claim Pend Management Assets like Systems or Software solutions.

Claim Pend Management Data Life Cycle Phases:

Data Lifecycle (or Life Cycle) for any and all data is the period from the "inception" of data through to its ultimately being "purged" from existence. This is no different for Claim Pend Management related data.

Like the data associated with any other professional IT Discipline, Claim Pend Management related data adheres to the following common Data Lifecycle Phases:

Figure: Claim Pend Management Lifecycle Phases

Inception: Data is in it's raw idea-like form and is not ready for consumption by the general population because it has not been documented or registered, anywhere, in a formal manner.

Creation and Registration: Data is formally put into existence for day-to-day use by appropriate stakeholders.

Iterative Maintenance: Data is in a mode of constant use and is updated and modified, as needed, to meet the needs of daily use by various stakeholders.

Decommission and Deletion: Data is prepared for deletion and eventually deleted from daily operational use but still exists for administrative or organizational purposes, such as historical auditing. It can be restored to any one of its relevant last states and, therefore, can be brought back into existence for day-to-day use.

Purged From Existence: Data is completely removed from an environment with no means to restore or reconstruct it, without recreating it from scratch and with no guarantees that it will match it's previous state.

The above Life Cycle Phases represent the high level transitions that occur from the inception of Claim Pend Items or Entities all the way through to their complete elimination from existence. A more detailed breakdown of these transitions or phases represents what are referred to as "Claim Pend Management States."

The SDLC is a means for facilitating and controlling how IT Professionals deliver Assets, such as Claim Pend Management Systems and Software. In this case, you should default to the master SDLC, which is used to deliver any Asset of any type, including those associated with the Claim Pend Management discipline.

There are probably no greater or more important tools for providing Claim Pend Management transparency and direction than the collection, ordering, categorizing, grouping, and maintenance of all related Claim Pend Items. In other words, Claim Pend Management Inventories.

In short, an Inventory represents a list of individual things or instances of things that are typically all of the same Noun Type or Data Type, where these instances are described and detailed by their Attributes, along with the Data and Information that act as values for such Attributes.

Inventories are also used for solid decision making. Good decisions, either strategic or tactical, are made based on having good Data and Information. And, good Data and Information only come from taking the time to follow best practices associated with Inventory Management. It's only through building such Inventories that an enterprise can achieve solid Claim Pend Management Business Intelligence and Reporting.

Also, it's these very same Inventories that act as the foundation for understanding and managing Total Cost of Ownership (a.k.a. "TCO") for Claim Pend Management. Without such Inventories, trying to understand your costs can be nothing more than uneducated guessing.

The obvious place to start is with Claim Pend Inventories and then move on to surrounding Inventories that are directly and indirectly related to Claim Pend Management.

Additionally, there are many other types of Inventories that are common and important to Claim Pend Management, which include but are not limited to examples such as:

If you and/or your enterprise are not collecting and maintaining such Inventories, you're probably considered to be very low on the efficiency and effectiveness maturity scale.

It's important to keep in mind that collecting and managing Claim Pend Management Inventories is something that should be performed across all phases of Claim Pend Management Lifecycle and across all Environments (i.e. Claim Pend Management Environments). Both are considered to be very important Best Practices. For example, you and/or your enterprise cannot get a complete understanding of Claim Pend Management costs or impacts without knowing all related Inventory Items in all environments. And, tracking across all lifecycle phases gives a temporal perspective that is important for things like problem analysis, historical reporting, and the reconstruction of state (i.e. Configuration Management).

NOTE: Claim Pend Management Inventories are also important for other enterprise functions, such as Architecture and Design. Such Inventories represent the foundation for understanding an enterprise's Current State and are critical for planning Future State and any related strategies, roadmaps, and transition plans for facilititating change.

Building environments that are specific to and for the discipline known as Claim Pend Management is no different than doing so for any other discipline area. The reader should, therefore, refer to the IT Environment Framework to understand such environments.

As with any professional Discipline, the place to start with when dealing with Claim Pend Management specific metrics is with standard metrics categorizations. Standard Metrics Categorizations, or what are commonly referred to as "SMCs," include but are not limited to...

Claim Pend Management Quantitative Metrics: Quantitative metrics for Claim Pend Management often revolve around the "counting" of key constructs that are associated with the Discipline. For example, the number of Claim Pend Items or Entities that have been Created, Edited or Modified, Copied or Cloned, Destroyed, Archived, Restored, etc. (Note the correlations to key Claim Pend Management Verbs!). Also, the counts for things like the number of Claim Pend Management Stakeholders, such as but not limited to Paying Customers, End Users, Employees, Consultants, etc. are also very useful.

Claim Pend Management Qualitative Metrics: Qualitative metrics for Claim Pend Management often revolve around concepts such as Claim Pend Management Defects, Failures, Problems, Incidents, and/or Issues. So, for example, if we were to capture the number of Claim Pend Management Defects (i.e. their counts) over time, we could do things like see if Defect quantities are going up or down, over time, allowing us to explore that area for things like correlating Causes and Effects.

Claim Pend Management Time Metrics: When dealing with Claim Pend Management Time Metrics, there are usually two forms. The first was introduced in the previous paragraph, which has to do with capturing and measuring things like Quantitative or Qualitative Metrics, over time. In this case, we capture other metric categories, over time, with the intent to see how they change and perform, based on modifications to the Claim Pend Management Operating Environment. The second form of Time related metrics has to do with system or operational performance, such as in the case of how long it takes to process a Claim Pend Management Request, from the time it is created to the time the Requester gets a satisfactory deliverable that allows him or her to move on with his or her work.

Claim Pend Management Utilization Metrics: Utilization Metrics specifically have to do with the consumption of Claim Pend Management specific solutions or deliverables. For example, tracking the number of Claim Pend Management Service Requests, over periods of time, along with their corresponding Claim Pend Management Deliverables, allows one to measure how active Claim Pend Management Services are against other Services that may exist within the Enterprise.

Claim Pend Management Financial Metrics: As is always the case for any single Discipline, Financial Metrics for Claim Pend Management always revolve around things like revenue, expenses, and profits, both, for operators of the Service or Services and for consumers of the Service or Services. For example, if a Claim Pend Management Request is invoked by a Claim Pend Management Customer (acting as the "Requester"), it becomes important to be able to identify and understand what the cost is to that Customer who is invoking the Request, and it also becomes important to understand why that cost is what it is. In the case of Services that do not yield revenue or profits, measuring costs is a strong way to, at very least, help understand the costs associated with each Service being performed by, within, external to, and for the Enterprise and its Customers.

Note: It's important to understand that, when it comes to metrics, enterprises should take a "Crawl," "Walk," "Run" approach to collecting, working with, and understanding them. That is, you cannot get to complex metrics collection, dissection, analysis, and understanding until you start with basic metrics and slowly work your way to more complex metrics representations.

One of the most important concepts you will learn about Claim Pend Management (or any Discipline, for that matter) is the notion of implementing the Discipline as an accountable, planned, controlled, transparent, and managed "Service."

In short, Services represent a logically "bounded" and repeatable sets of work types, activities or tasks that are performed by humans and/or machines, with the specific intent to provide outputs or deliverables, in the form of solutions for the requesting Stakeholders who are commonly considered the customers of such Services. In other words, we perform and/or provide a Service to deliver very specific solutions to very specific Stakeholders who are looking for a means to solve a certain problem they have.

A Claim Pend Management Service is defined as:

"1. A set of solutions, either transactional (i.e. Transactional Claim Pend Management Services) or dial-tone (i.e. Dial-Tone Claim Pend Management Services), that are being or have been put in place to yield an intended, controlled, expected, repeatable and measurable set of results or deliverables for Claim Pend Management specific Customers, Consumers or Clients.

NOTE: Claim Pend Management Service Consumers or Clients can be either Human Resources or Systems."

All Services, including Claim Pend Management Services, can be performed manually (i.e. by people), automatically (i.e. by machines such as Computers), or by a combination of the two (i.e. a hybrid that is both manually and automated).

Also, all Services, including Claim Pend Management Services, can be either transactional or dial tone, in nature.

In the case of Transactional Services for Claim Pend Management, a Service Request is submitted and that Request is fulfilled as part of a process that is either manual, automated, or a hybrid of both (e.g. a Service to perform maintainance on your Claim Pend Management System).

In the case of Dial Tone Services for Claim Pend Management, a Service is expected to be up, running, available, and accessible to an End User so that he/she/it may perform some controlled and highly repeatable function (e.g. a "Claim Pend Management System" that is up and running all the time).

Claim Pend Management Service Components: The successful implementation of Claim Pend Management as a set of Services for your enterprise usually implies that a number of key components have been established to support it. These components are:

A clearly documented and socialized Claim Pend Management Service Owner that is held accountable for Service performance, quality, and cost.

A clearly documented and socialized Claim Pend Management Service Provider, Organization or Group who is performing the Service or work.

A clearly documented and socialized inventory of all Claim Pend Management Service Inputs, including Claim Pend Management Service Requests and any artifacts necessary to support such Requests so that consumers of the Service know how to engage and request or take advantage of them.

For every Claim Pend Management Service Input, a clearly documented and socialized inventory of Claim Pend Management Service Outputs, making it clear to consumers what they can expect to receive as a result of a successful Service Request.

For every Claim Pend Management Service Input, a clearly documented and socialized inventory of the work being performed by the Service Provider to achieve such Outputs or Deliverables.

For every Claim Pend Management Service Input, a clearly documented and socialized inventory Service Level Agreements (e.g. Service Availability, Service Duration, Service Guarantees, etc.) that can be used to set expectations and measure actuals against for said Service Outputs.

Clearly specified Claim Pend Management Service Costs that help set expectations for Service Requesters (i.e. the cost of a request) and that provide clear transparency to the organizations that fund and sponsor such Services (i.e. the Total Cost of Ownership (TCO) your Service(s).

Claim Pend Management Service Request Patterns (Estimation Creation, Modification, Decommission, Support/Incidents, Complaints, etc.) in order to create intuitive and repeatable user experiences across different Service Types.

Clearly understand what Claim Pend Management Service Resources are required, human or otherwise, to create and deliver your Claim Pend Management Service Deliverables, in a repeatable, cost-efficient, timely, and high quality manner.

For every Claim Pend Management Service Request, understand the chargeback mechanism, in order to recoup your Service Costs.

For every Claim Pend Management Service, it's important to understand the skills that are required, will need to be developed, and will need to be maintained by Service Resources, in order to deliver each Service Deliverable.

It's important to understand who your Claim Pend Management Service Stakeholders are, this includes but is not limited to your Customers, Consumers, Clients, Sponsers, etc. are, as well as the types of problems it is that they're trying to solve or interests that they will have in your Services.

Claim Pend Management Ownership: The most important thing to understand about a Claim Pend Management Service is that, in order for such a Service to be successful, there must be a clear and accountable Owner for it. That is, there needs to be a very clear and accountable named person or organization that owns and is fully responsible for the Service, all of its sub-Services and, most importantly, all of the Service's "Outcomes." Without clear ownership, Services are almost never successful. And, for those few occasions where Services are successful without clear ownership, you can assume that they're successful because the people working in those Service areas are acting as heroes, or... the those Services are just plain lucky (that kind of luck doesn't last for long).

Claim Pend Management Service Inputs: There are typically two types of inputs to any Claim Pend Management Service. The first is what is known as a "Claim Pend Management Service Request" and the second really represents any and all supporting artifacts that are necessary to support such requests, including but not limited to Data and Information in the form of Documents, either electronic or paper in form. Many would argue that the "money" to pay for the Service execution of the Request would be the third but, for now, we will assume that payment is controlled through the Data and Information provided to the Service Operators, in support of the Request.

Claim Pend Management Service Outputs: The outputs of any Service are often referred to as the Service's Deliverables. Therefore, the readers should be aware that the terms "Claim Pend Management Outputs" and "Claim Pend Management Deliverables" are synonymous and interchangeable. All work performed in any enterprise is, by default, a Service that is being performed for someone else and, therefore, all work or Services yield results. These results are the Service's Outputs or Deliverables and a good Service ensures that such Outputs are appropriately documented to the consumers of said Service. This means that for any given Claim Pend Management Service Request Type or Category there will be one or more clearly defined and documented Outputs or Deliverables, making it clear to the consumer what he, she, or they will get in response to their Request. This can be as simple as an answer to a question or as complex as the Merger of two enterprises.

Claim Pend Management Service Levels: Service Levels represent "performance agreements," contractual or otherwise, that dictate how well a Claim Pend Management Service should perform, most often keeping the Customers, Consumers, Clients or End Users of the Service in mind. Claim Pend Management Service Levels can come in many forms and are often worked out by the Customers paying for the Services and the Service Providers who sell or provide the Services. In many cases, Service Levels are also self-imposed by the Service Providers performing the Services as a means to set expectations for Service Customers. In short, Claim Pend Management Service Levels are constraints, limitations, and/or expectations that are tied directly to Claim Pend Management Service Deliverables. They represent measures for things like quality, efficiency, and cost against said Deliverables or Outputs that allow the consumer of such Services to measure what they actually get against what they expected to get.

Assuming an enterprise pursues the establishment of Claim Pend Management as a set of controlled Services, there are three common paradigms for doing so. These include:

A "Centralized Claim Pend Management" implementation paradigm

A "Federated Claim Pend Management" implementation paradigm

A "Hybrid Claim Pend Management" implementation paradigm

Centralized Claim Pend Management is defined as:

"1. The term or phrase that implies establishing and/or practicing the Discipline known as Claim Pend Management as a concentric and singular set of organizations and services, usually in order to serve an entire enterprise, regardless of geographic location, further implying full centralization and no federation of any and all Claim Pend Management associated Work, Activities, Actions, Tasks, Capabilities and/or Services."

Federated Claim Pend Management, which is also referred to as Decentralized Claim Pend Management, is defined as:

"1. The term or phrase that implies establishing and/or practicing the Discipline known as Claim Pend Management in multiple pockets, communities, or organizations, further implying no centralization in the implementation and execution of Claim Pend Management associated Work, Activities, Actions, Tasks, Capabilities and/or Services."

There are clear tradeoffs to each of the two models. For example, in a Centralized paradigm, it's normally easier to coordinate work and provide broad coverage, across many areas of the enterprise and relevant stakeholders. However, it becomes far more difficult for a centralized organization to properly fund and staff resources and services in order to perform all required work across all stakeholders, in a much larger enterprise.

It's also important to note that a third paradigm also exists as an option. This is known as a Hybrid Claim Pend Management paradigm or model. In this case, there is a centralized Claim Pend Management organization that is often responsible for things like centralized governance, command, control, and communications, while federated staff and services deal with localized forms of Claim Pend Management. In this type of paradigm, federated staff and services usually report direclty into their local management but may have matrix reporting or responsibilities into the Centralized Claim Pend Management organization.

A "Principle" is defined as being: "A professed assumption, basis, tenet, doctrine, plan of action or code of conduct for activities, work or behavior." Therefore, we can deduce the definition of "a Claim Pend Management Principle" to be:

Claim Pend Management Principle:"1. A professed assumption, basis, tenet, doctrine, plan of action or code of conduct for any activities, work or behavior associated with the Discipline known as Claim Pend Management."

A "Best Practice" is defined as being: "One or more Activities, Actions, Tasks or Functions that often do not conform with strict Standards and that have evolved, over time, to be considered as conventional wisdom for consistently and repeated achieving Outcomes or Results that can be measured as being equal to or above acceptable norms." Therefore, we can deduce the definition of "a Claim Pend Management Best Practice" to be:

Claim Pend Management Best Practice:"1. One or more Claim Pend Management related Activities, Actions, Tasks or Functions that often do not conform with strict standards and that have evolved, over time, to be considered as conventional wisdom for consistently and repeatedly achieving Outcomes or Results that can be measured as being equal to or above acceptable norms."

The plural form of this term would be "Claim Pend Management Best Practices."

Common Claim Pend Management related principles and best practices exist to help achieve higher than average expectations of quality and to ease in the implementation, support, operations, and future change associated with the solutions industry professionals put in place to address the needs of this Discipline and all its related stakeholders.

While this entire document is meant to represent and serve as a set of common principles and best practices for Claim Pend Management, the following list represents a summary of some very basic examples of what implementers, supporters, and operators of Claim Pend Management should constantly be working toward:

Principle or Best Practice

Description

Establish and always have very clear Ownership for Claim Pend Management.

Establishing, publishing and socializing clear Ownership for Claim Pend Management allows an enterprise and all its Resources, regardless of their geographic location, to assign accountability for all aspects of the Discipline. It also ensures that there's always at least one person that everyone can go to for transparency into the Discipline as well as for handling work that is associated with the Discipline.

As an IT professional, there are probably few things that are as important as knowing what is or is not in your portfolio, as well as understanding key traits about your portfolio. You cannot achieve this without the transparency provided by your inventories. Therefore, it is critical that you clearly define, collect, manage, and govern any and all relevant Claim Pend Management inventories. Lack of Claim Pend Management Inventories means no transparency, a chaotic and immature environment, and (even worse) the implication that you don't know how to do your job.

Always use standard terminology for Claim Pend Management, in order to standardize communications between stakeholders.

It is often argued that the biggest mistake you can make is to create your own words and/or your own definitions, when communicating with others. There is no place where this is more accurate than in the field of Information Technology. IT Stakeholders make up their own words and definitions far too often, or let their business constituents do so. When you make up words or definitions, or you let others do so, you're creating a grave injustice for your organization. Self invented terminology and grammar often leads to poor communications, which in turn leads to redundancy of solutions, higher complexity of environments, slower delivery times, and much higher costs. Therefore, the IF4IT always recommends that you leverage standard terminology for Claim Pend Management, whenever possible.

Centralization of Claim Pend related data.

While often impossible to centralize and collocate all Claim Pend related data and information, especially in a geographically dispersed environment, Claim Pend Management related stakeholders should always strive to centralize all data and information. The goals are to eliminate data fragmentation, improve source of truth for data, reduce the number of systems needed to support stakeholders, reduce the complexity of solutions, improve usability, and to ultimately reduce the costs associated with Claim Pend Management.

In order to successfully set up the discipline of Claim Pend Management and its related Services, it is critical to clearly define, track, and constantly analyze Claim Pend Management metrics. Such metrics include but are not limited to Supply and Demand Metrics (i.e. Operational Metrics), Performance Metrics, Quality Metrics, and Financial Metrics.

Transparency of Claim Pend related data.

Stakeholders should always strive to make any and all Claim Pend Management data transparent to all other appropriate stakeholders, at a minimum, and often to the entire enterprises. The exception when private user data must be protected. Many stakeholders often make the mistake of treating internal operational data as private or protected. This often creates a data silo and will often lead to internally silo-ed organizations that revolve around such data silos.

Do not let "perfection" of Claim Pend Management solutions stand in the way of "good enough solutions".

Often, Claim Pend Management stakeholders "overthink" solutions, leading to the impression that best-of-breed or perfect solutions are more effective than "good enough" solutions. Experience tells us that "good enough" is, almost always, the better path to follow. We live in an age where technologies grow old in the blink of an eye. Even the implementation of something that looks perfect, today, will look antiquated, tomorrow. This is especially true if your enterprise doesn't have a long term funding plan and commitment to improvements and upgrades of the solution(s) put in place.

One of the most common errors many enterprises make is to create solutions from scratch or without the guidance, assistance and/or experience of others who have created such solutions, before them. Whenever possible, the IF4IT recommends that you research existing Standards, Best Practices, and Guiding Principles to avoid the mistakes of others, while also gaining from their successes. Remember, we live in a vast world. Chances are very high that someone else has already experienced the pain you're about to create for yourself. Wise people will always look to learn from such people's experiences before they go down the road of implementing their own solutions.

Work toward and maintain a Single Source of Truth (SSoT), whenever possible.

While it may be impossible to truly maintain a Single Source of Truth (SSoT) for all data items at all times, especially in the case where the same data entity or instance enters an enterprise through unique data channels, it is an accepted, industry-wide best practice to always work toward such a goal.